The Objective Acoustic Analysis Of Oesophageal Voice By Speech Aid Appliance After Total Laryngectomy

Objects The biggest suffering of patients is losing phonation which total laryngectomy bings to.Esophageal speech ,tracheo-esophageal fistuloplasty and tracheo-esophageal puncture with voice prosthesis is usual methods of voice rehabilitation. The postoperative quantity of patients without phonation was from 20% to 30%. The subjective assessment of pronunciation has been reported and using esophageal voice device can improve the success rate of pronunciation. The purpose of this investigation was to objectively evaluate the acoustic quality of esophageal voice by speech aid appliance after total laryngectomy. Methods All objects of the experimental group were completely chosen from the patients with laryngeal carcinoma and received total laryngectomy in department of Otorhinolaryngology Head Neck Surgery of Affiliated Hospital of Ningxia Medical University from March 1994 to July 2005. we chose randomly 39 patient obtained Blom-Singer phonation rehabilition, 24 cases are still alive . Living and can contacted with the inspection only 10 cases .Among them 5 volunteers as tracheoesophageal pronunciation group;4 cases who install prothesis but can't pronounce,1 case had to use speech aid appliance cause grow granulation ,a total of 5 cases as group of oesophageal voice by speech aid appliance12 the normal male of age basic matching as control group were studied.Acoustics ampling of sustained vowel"a"were Measured for (fundamental frequency , jitter , shimmer and signal-to-noise ratio).Meanwhile,we studied the maximal Phonation time and intensity of the vowel"a"Were measured. Results 1. Oesophageal voice by speech aid appliance group, tracheoesophageal group,and the normal voice group,The mean fundamental frequeney is 155.73Hz,147.52Hz and 168.87 Hz, respectively.The mean fundametal frequeney in oesophageal voice by speech aid appliance group and in traeheo-oesophageal speech group were lower than in nomal voice group,there was statistical significance(p<0.05). 2. Oesophageal voice by speech aid appliance group, tracheoesophageal group,and the normal voice group,The mean jitter is 1.89%,1.85% and 0.17%,The mean shimmer is6.74%,6.57%and1.70% respectively.the mean harmonics to noise ratio is 10.97dB,10.27dB and 21.19dB.The mean jitter,shimmer esophageal voice by speech aid appliance were higher than in normal voices(P<0.01),the mean harmonics to noise ratio esophageal voice by speech aid appliance was lower than in normal voices(P<0.01).3.There was no statistically significant difference in the mean intensity between in esophageal voice by speech aid appliance and in normal voices(P>0.05).4. The sonograph showed the voice of speech loud and clear. 5. Oesophageal voice by speech aid appliance group, tracheoesophageal group,and the normal voice group, the maximum phonation time is 10.77 seconds,6.10 seconds and 15.81 seconds, The greater maximal phonation time in oesophageal voice by speech aid appliance group and in traeheo-oesophageal speech group were lower than in normal voice group, there was statistical significance(P<0.01),There were greater maximal phonation time in oesophageal voice by speech aid appliance,but Compare with normal voice,the maximal phonation time are lower(P<0.05). the numer of syllable in a breath there was statistical significance(P>0.05). 6. the maximum phonation time of oesophageal voice by speech aid appliance was higher than traeheo-oesophageal speech, there was statistical significance(P<0.05).Conclusion 1.The mean fundamental frequency in oesophageal voice by speech aid appliance and in traeheo-oesophageal speech were lower slightly than in normal voices,which refect that there are lower. 3.The mean jitter,shimmer in oesophageal voice by speech aid appliance and in traeheo-oesophageal speech were higher than in normal voices,the mean HNR were lower than in normal voices.It is noise and more thick . 3.There were no statistically significant difference in the mean intensity among the there.4. The sonograph showed the voice of oesophageal voice by speech aid appliance and i traeheo-oesophageal speech clear and loud. It can meet the needs daily conversation..5.There were agreater maximal phonation time in oesophageal voice by speech aid appliance and in traeheo-oesophageal speech,but compare with normal voice,the maximal phonation time is lower.For Great majority patients,the number of syllable in a breath reachedâ… grade,which indicated that patients have ability of commnunieation. 6. the maximum phonation time of oesophageal voice by speech aid appliance was higher than traeheo-oesophageal speech , it showed that the oesophageal voice by speech aid appliance be more fluent. Therefore,the speech of oesophageal voice by speech aid appliance is better option for patients with alaryngeal. especialy for those failure by traeheo-esophageal prosthesis voice, it is undoubtedly a better choice.